FEVER IN EARLY INFANCY

Further understanding of the physiology of fever and meta-analysis of previous studies of febrile illness in infants under 3 months of age h ave contributed to a more rational clinical approach in these young ba bies. More detailed analysis of the use of the white cell count, lumba r puncture, C-reactive protein, urinalysis and chest radiography has i mproved the efficiency of investigation. The risk of bacterial infecti on in well-looking, febrile young infants is 5-8%. The use of the Roch ester criteria enables this risk to be reduced to 1% if all criteria a re satisfied. Decision analyses have delineated alternative management strategies but different environments, illness prevalence, observer e xperience and parent reliability need to be considered.